<style>
    .layui-iconpicker-body.layui-iconpicker-body-page .hide {
        display: none;
    }
</style>
<link rel="stylesheet" href="/static/plugs/lay-module/autocomplete/autocomplete.css?v={$version}" media="all">
<div class="layuimini-container">
    <form id="app-form" class="layui-form layuimini-form">

        <div class="layui-form-item">
            <label class="layui-form-label">名称</label>
            <div class="layui-input-block">
                <input type="text" id="name" name="name" class="layui-input" lay-reqtext="请输入名称" placeholder="请输入名称" value="">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">关键字</label>
            <div class="layui-input-block">
                <input type="text" id="keyword" name="keyword" class="layui-input" lay-reqtext="请输入名称" placeholder="请输入名称" value="">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">联系电话</label>
            <div class="layui-input-block">
                <input type="text" id="mobile" name="mobile" class="layui-input" lay-reqtext="请输入联系电话" placeholder="请输入联系电话" value="">
            </div>
        </div>

        <div class="layui-form-item">
            <label class="layui-form-label">地址</label>
            <div class="layui-input-block">
                <input type="text" id="address" name="address" class="layui-input" lay-reqtext="请输入名称" placeholder="请输入名称" value="">
            </div>
        </div>

        <div class="layui-form-item">
            <label class="layui-form-label">统一社会信用代码</label>
            <div class="layui-input-block">
                <input type="text" id="license_num" name="license_num" class="layui-input" lay-reqtext="请输入统一社会信用代码" placeholder="请输入统一社会信用代码" value="">
            </div>
        </div>

        <div class="layui-form-item">
            <label class="layui-form-label">营业执照</label>
            <div class="layui-input-block layuimini-upload">
                <input name="license" class="layui-input layui-col-xs6" placeholder="请上传营业执照" value="">
                <div class="layuimini-upload-btn">
                    <span><a class="layui-btn" data-upload="license" data-upload-number="one" data-upload-exts="png|jpg|ico|jpeg" data-upload-icon="image" data-upload-mimetype="image/*"><i class="fa fa-upload"></i> 上传</a></span>
                    <span><a class="layui-btn layui-btn-normal" id="select_license" data-upload-select="license" data-upload-number="one"><i class="fa fa-list"></i> 选择</a></span>
                </div>
            </div>
        </div>

        <div class="layui-form-item">
            <label class="layui-form-label">减点数</label>
            <div class="layui-input-block">
                <input type="number" id="reduce_percentage_point" name="reduce_percentage_point" class="layui-input" lay-reqtext="请输入名称" placeholder="请输入名称" min="0" value="">
            </div>
        </div>

        <div class="hr-line"></div>
        <div class="layui-form-item text-center">
            <button type="submit" class="layui-btn layui-btn-normal layui-btn-sm" lay-submit>确认</button>
            <button type="reset" class="layui-btn layui-btn-primary layui-btn-sm">重置</button>
        </div>

    </form>
</div>